Featured Research

from universities, journals, and other organizations

Meniscal Damage And Joint Malalignment Predictors Of Cartilage Loss

Date:
June 2, 2008
Source:
Wiley-Blackwell
Summary:
Marked by cartilage and bone degradation, progressive knee osteoarthritis (OA) is believed to result in part from a combination of several local mechanical factors. Lack of joint stability, poor joint alignment and injuries to the disks of meniscal tissue that cushion the knee all affect load distribution and the toll to the vulnerable OA knee. However, in studies of knee OA progression, either meniscal damage or malalignment has been considered, but not both together, and no studies have included joint laxity.

Marked by cartilage and bone degradation, progressive knee osteoarthritis (OA) is believed to result in part from a combination of several local mechanical factors. Lack of joint stability, poor joint alignment and injuries to the disks of meniscal tissue that cushion the knee all affect load distribution and the toll to the vulnerable OA knee. However, in studies of knee OA progression, either meniscal damage or malalignment has been considered, but not both together, and no studies have included joint laxity.

Unlike radiographs, magnetic resonance imaging (MRI) can distinguish articular cartilage from meniscal tissue and detect the impact of specific factors on OA progression. Almost all studies of knee OA progression with MRI outcomes define cartilage loss with qualitative cartilage assessments. For a clearer picture of the role of various mechanical factors in knee OA, researchers at Northwestern University and Salzburg Univeristy applied quantitative measures of cartilage loss—decreases in cartilage volume and thickness and an increase in bare bone area—as well as cartilage integrity score.

Their results indicate three factors that independently predict cartilage loss with a direct impact on knee OA: medial meniscal damage, lateral meniscal damage, and varus, or bow-legged, malalignment of the knee joint. Notably, quantitative cartilage loss outcome measures were more sensitive in revealing these relationships than previously applied qualitative approaches.

The study’s participants, 153 women and men with radiographic evidence of knee OA, were recruited from local senior citizens groups and the registry of the Beuhler Center on Aging at Northwestern University. The mean age was 66 years and the mean BMI was 30. None of the subjects had a history of rheumatoid arthritis, gout, joint infection, or meniscectomy. A total of 251 osteoarthritic knees were thoroughly scanned with MRI and rigorously studied. Meniscal damage and meniscal extrusion were graded using the Whole-Organ MRI Score (WORMS). Varus-valgus alignment and medial-lateral laxity were also measured.

Focusing separately on medial and lateral segments of tibial and weightbearing femur cartilage of the knee joint, cartilage volume, percentage of subchondral bone covered with cartilage, exposed subchondral bone area, and the average thickness of cartilage were measured using specialized software. Cartilage integrity was also scored. Two years later, the entire process was repeated. Odds ratios were determined for each of the four mechanical factors using logistic regression analysis, adjusting for age, sex, BMI, and the other factors.

Medial meniscal damage significantly increased the likelihood of cartilage volume loss, cartilage thickness decrease, and denuded bone increase in both the medial tibial and the medial weightbearing femoral segments. Similarly, lateral meniscal damage predicted quantitative cartilage loss in both the lateral tibial and the lateral weightbearing femoral segments. Varus malalignment was strongly associated with cartilage loss from each medial surface; valgus (knock-knee) malalignment was not associated with lateral surface loss. Meniscal extrusion and joint laxity had inconsistent effects. Using the qualitative cartilage assessment, however, no significant relationship with outcome was detected for either meniscal damage or malalignment.

Dr. Leena Sharma, the study’s leading author and spokesperson, commented “It is important to note that local factors, such as those examined in this study, may participate in vicious circles with the worsening of knee OA. Whenever along the OA disease timeline a local impairment develops, it may contribute to subsequent OA progression and cartilage loss, especially given the vulnerable milieu of the already damaged OA knee. Ultimately, strategies that interrupt these vicious circles may be especially powerful."


Story Source:

The above story is based on materials provided by Wiley-Blackwell. Note: Materials may be edited for content and length.


Journal Reference:

  1. Leena Sharma, Felix Eckstein, Jing Song, Ali Guermazi, Pottumarthi Prasad, Dipali Kapoor, September Cahue, Meredith Marshall, and Dorothy Dunlop. Relationship of Meniscal Damage, Meniscal Extrusion, Malalignment, and Joint Laxity to Subsequent Cartilage Loss in Osteoarthritis Knees. Arthritis & Rheumatism, June 2008; 58:6 pp. 1716-1726

Cite This Page:

Wiley-Blackwell. "Meniscal Damage And Joint Malalignment Predictors Of Cartilage Loss." ScienceDaily. ScienceDaily, 2 June 2008. <www.sciencedaily.com/releases/2008/06/080602160758.htm>.
Wiley-Blackwell. (2008, June 2). Meniscal Damage And Joint Malalignment Predictors Of Cartilage Loss. ScienceDaily. Retrieved October 2, 2014 from www.sciencedaily.com/releases/2008/06/080602160758.htm
Wiley-Blackwell. "Meniscal Damage And Joint Malalignment Predictors Of Cartilage Loss." ScienceDaily. www.sciencedaily.com/releases/2008/06/080602160758.htm (accessed October 2, 2014).

Share This



More Health & Medicine News

Thursday, October 2, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Pregnancy Spacing Could Have Big Impact On Autism Risks

Pregnancy Spacing Could Have Big Impact On Autism Risks

Newsy (Oct. 1, 2014) A new study says children born less than one year and more than five years after a sibling can have an increased risk for autism. Video provided by Newsy
Powered by NewsLook.com
Robotic Hair Restoration

Robotic Hair Restoration

Ivanhoe (Oct. 1, 2014) A new robotic procedure is changing the way we transplant hair. The ARTAS robot leaves no linear scarring and provides more natural results. Video provided by Ivanhoe
Powered by NewsLook.com
Insertable Cardiac Monitor

Insertable Cardiac Monitor

Ivanhoe (Oct. 1, 2014) A heart monitor the size of a paperclip that can save your life. The “Reveal Linq” allows a doctor to monitor patients with A-Fib on a continuous basis for up to 3 years! Video provided by Ivanhoe
Powered by NewsLook.com
Attacking Superbugs

Attacking Superbugs

Ivanhoe (Oct. 1, 2014) Two weapons hospitals can use to attack superbugs. Scientists in Ireland created a new gel resistant to superbugs, and a robot that can disinfect a room in minutes. Video provided by Ivanhoe
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins